Initial experience with transvenous implantable cardioverter defibrillator lead systems: Operative morbidity and mortality

R. Frame, R. Brodman, Jay N. Gross, I. Hollinger, John Devens Fisher, Soo G. Kim, Kevin J. Ferrick, J. Roth, S. Furman

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Introduction of non-thoracotomy lead systems(TM) (Medtronic, Inc.) for the implantable cardioverter defibrillator (ICD) has expanded the indications for use of this mode of therapy. Patients previously considered 'too ill' to undergo a thoracotomy as well as patients who are at a high risk for developing sudden death but without previous cardiac arrest, are now considered candidates. The initial experience with the non-thoracotomy lead system at our institution was analyzed for morbidity and mortality. Thirty-four patients underwent attempted intravascular lead implantation, with 30 having initial successful implantation (88.2%). There were 23 males; average ejection fraction (EF) was 38.6%. Three patients developed pulmonary edema and low output immediately after the procedure. Three patients developed electromechanical dissociation during defibrillation threshold testing. A prolonged testing time for the non-thoracotomy lead system was noted when compared to the thoracotomy system (57.39 vs 32.30 min; P < 0.0000). There were more intraoperative morbidities with the non-thoracotomy leads than with the thoracotomy system. There were no perioperative deaths. The potential consequences of prolonged anesthesia time and extensive defibrillation threshold testing should be considered when choosing the route of ICD implant, the type of anesthesia, and the intraoperative testing protocol for each patient.

Original languageEnglish (US)
Pages (from-to)149-152
Number of pages4
JournalPACE - Pacing and Clinical Electrophysiology
Volume16
Issue number1 II
DOIs
StatePublished - 1993

Fingerprint

Implantable Defibrillators
Morbidity
Mortality
Thoracotomy
Anesthesia
Pulmonary Edema
Sudden Death
Heart Arrest
Lead

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Initial experience with transvenous implantable cardioverter defibrillator lead systems : Operative morbidity and mortality. / Frame, R.; Brodman, R.; Gross, Jay N.; Hollinger, I.; Fisher, John Devens; Kim, Soo G.; Ferrick, Kevin J.; Roth, J.; Furman, S.

In: PACE - Pacing and Clinical Electrophysiology, Vol. 16, No. 1 II, 1993, p. 149-152.

Research output: Contribution to journalArticle

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